FIT Home Screening Test Request Form

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Personal health information on this form is collected for the purposes of the provision of health care. Your information will be collected, used and disclosed only as permitted by the Health Information Act, RSPEI 1988, c H-1.41, and other applicable legislation. For more information on privacy and your personal health information, visit or contact 1-888-561-2233.

For example: C1B 0X1 or 12345
For example 902-555-5555